Date: 25 Mar 2025
Location: Remote, Remote, US
Company: firstsourc
Job Summary
We are seeking an Associate Director – BPaaS (Business Process as a Service) Product to lead the strategy, development, and execution of BPaaS solutions tailored for the healthcare payer industry. This role will drive product innovation, market positioning, and operational efficiency by leveraging automation, AI, and digital transformation in payer operations such as claims processing, member enrollment, provider network management, and risk adjustment. The ideal candidate will have a strong background in healthcare payer services, BPaaS platforms, and business transformation initiatives.
Key Responsibilities

BPaaS Product Strategy & Development:

• Define and execute the BPaaS product roadmap, aligning with payer market needs and emerging healthcare trends.
• Develop and optimize BPaaS offerings, including claims adjudication, enrollment, provider lifecycle management, utilization management, and regulatory compliance.
• Ensure seamless integration of BPaaS solutions with existing payer IT ecosystems (Facets, QNXT, HealthEdge, Epic, etc.).
• Drive automation, AI, and digital workflow enhancements to improve operational efficiencies and reduce costs.

Market Positioning & Business Growth:

• Conduct market research, competitive analysis, and customer feedback assessments to enhance BPaaS offerings.
• Collaborate with sales, marketing, and business development teams to position BPaaS solutions effectively.
• Engage with health plans, TPAs, and government payers to understand their pain points and customize solutions accordingly.
• Develop business cases, pricing models, and ROI analysis for new BPaaS offerings.

Cross-Functional Collaboration & Stakeholder Management:

• Partner with technology, operations, compliance, and finance teams to drive product innovation and execution.
• Work closely with clients, vendors, and technology partners to optimize service delivery and implementation.
• Ensure BPaaS solutions meet regulatory requirements (CMS, HIPAA, NCQA, SOC 2, and HITRUST standards).

Process Improvement & Performance Optimization:

• Drive automation, AI-driven analytics, and robotic process automation (RPA) to enhance BPaaS efficiency.
• Track and report KPIs, SLAs, and operational performance metrics to ensure continuous improvement.
• Identify risks, develop mitigation strategies, and implement best practices for operational excellence.

Qualifications & Requirements

Education & Experience:

• Bachelor’s degree in Healthcare Administration, Business, Information Systems, or related field (Master’s preferred).
• 8+ years of experience in BPaaS, healthcare payer operations, or healthcare technology solutions.
• 3+ years in a leadership role overseeing BPaaS product development, operations, or strategy.

Skills & Competencies:

• Deep expertise in payer operations, including claims processing, member services, provider management, and regulatory compliance.
• Strong understanding of BPaaS models, outsourcing strategies, and automation-driven service delivery.
• Experience with AI, RPA, cloud platforms, and digital transformation in healthcare payer space.
• Familiarity with EHR/EMR integrations, FHIR APIs, and healthcare data interoperability.
• Excellent stakeholder engagement, strategic thinking, and communication skills.

Preferred Qualifications:

• PMP, Six Sigma, or SAFe Agile certification.
• Experience with healthcare technology platforms (Facets, QNXT, HealthEdge, Pega, or similar BPaaS solutions).
• Knowledge of value-based care models, risk adjustment, and healthcare analytics.

Please refer the Job description for details